Welcome to question of the day #339

Welcome to question of the day #339

I work in community practice. I remember reading that around 70% of eye conditions can be diagnosed from the history and symptoms alone. Is this accurate?

I have read this too but can’t remember ever seeing any research to back it up.

However, I do know from my own clinical experience that symptoms the patient describes can be very helpful in alerting me to possible eye conditions. Signs of course can also be helpful but here I will concentrate on symptoms.

Here are the symptoms that give me strong clues as to the presence of a refractive and/or eye condition:

A child or teenager complaining of problems with distance vision while having clear near vision; is strongly suggestive of myopia.

A child or teenager complaining of blurred vision at all distances; hyperopia and/or astigmatism.

A child or teenager complaining of glare and halos around lights and photosensitivity; keratoconus.

An older person complaining of everything being misty/cloudy at all distances; cataract.

An older person complaining of difficulty reading near print while TV vision is okay; age-related macular degeneration.

There are many possible symptoms but these are the ones I commonly hear in community practice.

Others to look out for even though they are rarer than the list above are:

An adult of any age complaining of a curtain or shadow descending in the vision of one eye; progressive retinal detachment.

A few new floaters and/or one large new floater; posterior vitreous detachment.